Topical issues of nutritional support for patients with acute cerebrovascular accident

Abstract

The incidence of malnutrition in stroke patients varies widely and amounts to 6.1–62%. Risk factors for malnutrition in stroke patients are diverse and include the type and severity of stroke, gender, age, dysphagia, cognitive impairment, polysensory insufficiency, severe comorbid conditions, lack of adequate care, etc. At the same time, both the previous and the malnutrition that developed as a result of the stroke is the reason for a longer stay in the hospital, deterioration of functional results and an increase in mortality rates. The metabolic response to stress in stroke patients is represented by the hypermetabolism-hypercatabolism syndrome and is an essential component of the systemic inflammatory response, the development and progression of which leads to infectious complications, multiple organ dysfunction, increased hospitalization and increased mortality. Currently, clinical nutrition, or nutritional support (NS), is considered not only as a process of providing the body with energy and plastic material for the prevention and treatment of malnutrition, but also as an opportunity to influence structural, functional and metabolic processes in order to increase the adaptive reserves of the body, which is necessary for the recovery and rehabilitation of patients. The objectives of this review are the analysis of modern scientific data on clinical nutrition strategies and the development of an optimal algorithm of actions for the implementation of NS in clinical practice in the treatment and rehabilitation of stroke patients.